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aklap
Joined: 02 Oct 2004
Posts: 8302
Location: WI, USA
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 Posted: Fri Mar 14, 2008 12:18 pm Post subject: Serological and histological correlations in celiac disease. |
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Serological and histological correlations in celiac disease.
| Quote: | 1: Rom J Intern Med. 2007;45(3):263-8.Links
Tărmure S, Cristea A, Sămpelean D, Negrean V, Alexescu T.
14th Medical Clinic, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania. starmure@hotmail.com
The aim of this study was to compare the sensitivity of the serological markers in patients with non-treated celiac disease by determination of antiendomysium and anti-tissue-transglutaminase autoantibodies separately and together. At the same time we examined the correlation between the serum levels of the two antibodies and the severity of the histological lesions.
MATERIAL AND METHODS: The research included 26 persons (19 females, 7 males, age range 18-56 years) in whom the small bowel biopsy confirmed the villous atrophy. The sera of these patients were investigated by the determination of antiendomysium antibodies (AEA) and antitissue-transglutaminase antibodies (ATTG). For the morphological disorders we used the Marsh modified criteria. ATTG were determined by a sandwich-ELISA technique and AEA were dosed by indirect immunofluorescence technique.
RESULTS: 6 patients presented with partial villous atrophy (PVA), 7 with subtotal villous atrophy (SVA) and 13 with total villous atrophy (TVA). 23 persons were seropositive, having at least one of the two antibodies tested. The sensitivity of the serological investigation increased at 88% using both AEA and ATTG determinations. In patients with TVA, the sensitivity of ATTG was 100% and of AEA was 92%. In patients with SVA and PVA, the sensitivity of these antibodies was lower. Among the patients with SVA, 43% were negative for AEA and 50% for ATTG. The determination of AEA and ATTG together reduced the seronegativity at 15% in patients with SVA and at 34% in patients with PVA.
CONCLUSIONS: Antitissue-transglutaminase antibodies testing in patients with non-treated celiac disease is more sensitive than antiendomysium antibodies. The efficiency of the serological diagnosis improves when both AEA and ATTG are determined. Serum antibodies levels correlated very well with the severe histological alterations (TVA), but the correlation is not so good with SVA and PVA. So, we can tell that high levels of AEA and/or ATTG are suggestive for severe histological disorders in celiac disease.
PMID: 18333359 [PubMed - in process] |
Another test that shows...
tTG has some drawbacks when run all by itself - which many places do.
By my math [which is not all that good] 11.6% of these people were seronegative - even though they had confirmed villous atrophy. 
I've been saying that the tTG tests work great if there's total villous atrophy, but less effective when damage is lower. Here's another test that proves it.
Villi are toast
With TVA and the ATTG was 100% positive
With TVA and the AEA test was 92% positive
BUT...
Villi are not all toast
With SVA and the ATTG - 50% were seroneg [50% positive]
With SVA and the AEA - 43% were seroneg. [57% positive]
How would you like to be one of the 50% or the 43% that were denied getting biopsies based on just a single test?
Doing both tests together help...but knowing this info when you get your test results back, might put things in a different light!
Again, another reason to beg for a Complete Celiac Panel
_________________
Al
“We cannot all do great things, but we can do small things with great love.” Mother Teresa |
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aklap
Joined: 02 Oct 2004
Posts: 8302
Location: WI, USA
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| Posted: Wed Mar 26, 2008 1:24 pm Post subject: |
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bump
_________________
Al
“We cannot all do great things, but we can do small things with great love.” Mother Teresa |
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